TIERs Human Rights Violations Report Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Email *Fullname *FirstLast Incident of of Preferred NamePronoun *Age *Gender Identity *Sex Orientation *Phone No: *Type of Violation *Sexual Harassment/AbuseKitoPhysical AbuseDiscriminationKidnappingHate SpeechBatteryAssaultThreat to LifeRobberyRapeInvasion of PrivacyConversion of PracticeUnlawful ArrestBlackmailForceful EvictionDefamationExtortionWrongful DismissalOutingOthersDate of Incident *Type of Incident *Location of Incident *Summary of Incident *Summary of Support needed from TIERs *Submit